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Asthma in Michigan

Asthma in Michigan. Prepared by Epidemiology and Surveillance Staff of the Asthma Initiative of Michigan, Michigan Department of Community Health. Last Updated February 2006. Overview of Presentation. What is Asthma? The Asthma Initiative of Michigan Asthma Surveillance in Michigan

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Asthma in Michigan

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  1. Asthma in Michigan Prepared by Epidemiology and Surveillance Staff of the Asthma Initiative of Michigan, Michigan Department of Community Health Last Updated February 2006

  2. Overview of Presentation • What is Asthma? • The Asthma Initiative of Michigan • Asthma Surveillance in Michigan • Asthma Prevalence • Asthma Management and Quality of Life • Work-Related Asthma • Asthma Hospitalization • Asthma Mortality • Healthy People 2010 Goals for Asthma

  3. What is asthma?

  4. Asthma Defined • Chronic inflammatory disease of the airways • Causes recurrent episodes of • Wheezing • Breathlessness • Chest tightness • Coughing • Episodes are usually associated with airflow obstruction that is often reversible either spontaneously or with treatment Guidelines for the Diagnosis and Management of Asthma, NIH Publication 97-4051, July 1997.

  5. Risk Factors for Developing Asthma • Family history of asthma • Sociodemographic factors: • Prepubescent males • Post-pubescent females • Low socioeconomic status • Minority races • Allergy or family history of allergy • Premature birth • Low birth weight • Small airways at birth • Environmental exposures: Indoor & Outdoor (?)

  6. During an asthma attack…

  7. Environmental Risk Factors (Causes) INFLAMMATION Airway Hyperresponsiveness Airflow Limitation Precipitants Symptoms Mechanisms Underlying the Definition of Asthma Adapted with permission from Stephen T. Holgate, M.D., D.Sc. Guidelines for the Diagnosis and Management of Asthma, NIH Publication 97-4051, July 1997.

  8. Triggers of Asthma Attacks • Narrowing of airways occurs in response to inflammation or hyperresponsiveness to triggers, including: • Allergens • Infections • Diet/Medications • Strong Emotions • Exercise • Cold temperature • Exposure to irritants

  9. The Asthma Initiative of Michigan

  10. Recommendation Categories of the Michigan Asthma Strategic Planning Initiative Task Force (MASPI) • Foundation for Michigan Asthma Activities • Training for Clinical Diagnosis, Disease Management, and Asthma Education Services • Access to and Coordination of Health Care and Education Services • Environmental Action • Community Action

  11. Asthma Coalition for Northeast MI • Asthma Coalition of Northwest MI • Asthma Network of West MI • Detroit Alliance for Asthma Awareness • Eastern Upper Peninsula Asthma Coalition • Genesee Co. Childhood Asthma Task Force • Grayling Asthma Project • Jackson Asthma Coalition • Kalamazoo Area Asthma Coalition • Mid-Michigan Asthma Coalition • Southwest MI Asthma Coalition • Tri-County Asthma Coalition • Washtenaw Asthma Coalition • Asthma Epidemiology & Surveillance Work Group • Asthma in Schools Work Group • Environmental Quality Work Group • Evaluation Committee • Michigan Asthma Communication Network Committee • Quality Improvement in Asthma Care Work Group

  12. Asthma Coalitions of Michigan • Asthma Coalition for Northeast MI • Asthma Coalition of Northwest MI • Asthma Network of West MI • Detroit Alliance for Asthma Awareness • Eastern Upper Peninsula Asthma Coalition • Genesee Co. Childhood Asthma Task Force • Grayling Asthma Project • Jackson Asthma Coalition • Kalamazoo Area Asthma Coalition • Mid-Michigan Asthma Coalition • Southwest MI Asthma Coalition • Tri-County Asthma Coalition • Washtenaw Asthma Coalition

  13. Asthma Surveillance

  14. Asthma Surveillance – The Ideal • Track asthma occurrence and severity • Identify regional/demographic variations • Monitor asthma management & control, access to care, and quality of life • Track prevalence of risk factors and exposure to triggers • Monitor the effectiveness of public health interventions

  15. Pharmacy Claims Unscheduled Office Visit Scheduled Office Visit ED/Urgent Care Hospitalization Mortality Triggers Management Quality of Life Access Asthma Prevalence Causal Factors Asthma Surveillance – A Conceptual Model

  16. Asthma Surveillance in Michigan • Prevalence • Adult: Self report from the Michigan Behavioral Risk Factor Surveillance Survey (BRFSS) core questions • Child: Self report from the BRFSS, 18 years; Self report from the Youth Tobacco Survey (YTS), grades 6-12; Self report from the Youth Risk Behavior Survey (YRBS), grades 9-12. • Quality of Life and Asthma Management • Self Report from the BRFSS core and asthma module questions - Adults with current asthma only • School Health Education Profile (SHEP) Survey • Work-Related Asthma • Self Report from state added questions to the BRFSS • SENSOR surveillance of sentinel work-related asthma incidence • Hospitalization – Michigan Inpatient Database • Primary Diagnosis at Discharge, ICD-9-CM 493.XX • Mortality – Michigan Resident Death File • Primary Cause of Death, 1990-1998: ICD-9 493, 1999-present:ICD-10 J45 and J46

  17. Asthma Prevalence

  18. Prevalence Current Asthma for Children (<18 Years) and Adults (18 Years), Michigan Data Source: Michigan Behavioral Risk Factor Survey, 2002 and 2004

  19. Prevalence of Current Asthma for Adults ( 18 Years) by Race, Michigan, 2004 Data Source: Michigan Behavioral Risk Factor Survey, 2004

  20. Prevalence of Current Asthma for Adults ( 18 Years) by Education, Michigan, 2004 Data Source: Michigan Behavioral Risk Factor Survey, 2004

  21. Prevalence of Current Asthma for Adults ( 18 Years) by Household Income, Michigan, 2004 Data Source: Michigan Behavioral Risk Factor Survey, 2004

  22. Health Care Coverage for Michigan Adults ( 18 Years) by Current Asthma Status, 2004 Data Source: Michigan Behavioral Risk Factor Survey, 2004

  23. Prevalence of Lifetime Asthma for Children in Middle and High School, Michigan, 2003 Data Source: Youth Tobacco Survey, 2003

  24. Prevalence of Lifetime Asthma for Children in High School by Race, Michigan, 2003 Data Source: Youth Risk Behavior Survey, 2003

  25. Quality of Life and Disease Management for People with Asthma

  26. Perceived Health Status for Adults ( 18 Years) by Current Asthma Status, Michigan, 2004 * * * Statistically significant, p < 0.05 Data Source: Michigan Behavioral Risk Factor Survey, 2004

  27. Cigarette Smoking for Adults ( 18 Years) by Current Asthma Status, Michigan, 2004 Data Source: Michigan Behavioral Risk Factor Survey, 2004

  28. Weight Status for Adults ( 18 Years) by Current Asthma Status, Michigan, 2004 * * * Statistically significant, p < 0.05 Data Source: Michigan Behavioral Risk Factor Survey, 2004

  29. Illness/Symptoms Caused by Poor Air Quality for Adults ( 18 Years) by Current Asthma Status, Michigan, 2004 * * * Statistically significant, p < 0.05 Cook ML, Rafferty AP. 2005. Health Risk Behaviors in the State of Michigan: 2004 Behavioral Risk Factor Survey. Lansing, MI: MDCH, Bureau of Epidemiology, Epidemiology Services Division.

  30. Leisure-Time Physical Activity in the Last Month for Adults ( 18 Years) by Current Asthma Status, Michigan, 2004 Data Source: Michigan Behavioral Risk Factor Survey, 2004

  31. Flu Vaccination in the Past Year for Adults ( 18 Years) by Current Asthma Status, Michigan, 2004 * * * Statistically significant, p < 0.05 Data Source: Michigan Behavioral Risk Factor Survey, 2004

  32. Frequency of Asthma Medication Use in the Past 30 Days Among Adults ( 18 Years) with Current Asthma, Michigan, 2004 Data Source: Michigan Behavioral Risk Factor Survey, 2004

  33. Percent of Adults ( 18 Years) with Current Asthma that have Seen a Health Care Professional for a Routine Checkup of the Asthma in the Past 12 Months, Michigan, 2004 Data Source: Michigan Behavioral Risk Factor Survey, 2004

  34. Percent of Adults ( 18 Years) with Current Asthma that have Sought Urgent Asthma Treatment from either a Health Care Professional or Emergency Department/Urgent Care Center in the Past 12 Months, Michigan, 2004 Data Source: Michigan Behavioral Risk Factor Survey, 2004

  35. Occurrence of Asthma Symptoms in the Past 30 Days Among Adults ( 18 Years) with Current Asthma, Michigan, 2004 Data Source: Michigan Behavioral Risk Factor Survey, 2004

  36. Occurrence of Sleep Disturbing Asthma Symptoms in the Past 30 Days Among Adults ( 18 Years) with Current Asthma, Michigan, 2004 Data Source: Michigan Behavioral Risk Factor Survey, 2004

  37. Number of Days Unable to Work or Carry Out Usual Activities due to Asthma in the Past 12 Months for Adults ( 18 Years) with Current Asthma Michigan, 2004 Data Source: Michigan Behavioral Risk Factor Survey, 2004

  38. Symptom Severity for Michigan Adults with Asthma who took Asthma Medication Daily in the Past 30 Days, 2002 - 2004 Data Source: Michigan Behavioral Risk Factor Survey, 2004

  39. Prevalence of School-based Asthma Management Activities Among Public Schools with Grade 6 or higher, Michigan, 2004 Data Source: School Health Education Profile (SHEP) Survey, 2004

  40. Prevalence of School-based Asthma Management Activities Among Public Schools with Grade 6 or higher, Michigan, 2004, Cont. Data Source: School Health Education Profile (SHEP) Survey, 2004

  41. Work-Related Asthma

  42. Proportion of Adults whose Current Asthma May be Work-Related, Michigan, 2004 Identified by: Data Source: Michigan Behavioral Risk Factor Survey, 2004

  43. Proportion of Confirmed Work-Related Asthma Patients by Major Industry Type, Michigan, 1988-2004 Data Source: Rosenman KD, Reilly MJ, and Kalinowski DJ. 2004 Annual Report on Work-Related Asthma in Michigan. (http://oem.msu.edu//asthma/04AsthmaAnnRpt_all.pdf)

  44. Hospitalization for Asthma

  45. Rates* of Hospitalization due to Asthma by Sex, All Ages, Michigan, 2001-2003 *Uses 2002 MI population estimates and age adjusted to the 2000 US standard population. Data Source: Michigan Inpatient Database, Bureau of Epidemiology, MDCH.

  46. Rates* of Hospitalization due to Asthma by Sex and Year, All Ages, Michigan, 1990-2003 *Uses 1990-2003 MI population estimates and age adjusted to the 2000 US standard population. Data Source: Michigan Inpatient Database, Bureau of Epidemiology, MDCH.

  47. Rates* of Hospitalization due to Asthma by Age Group, All Ages, Michigan, 2001-2003 *Uses 2002 MI population estimates. Data Source: Michigan Inpatient Database, Bureau of Epidemiology, MDCH.

  48. Rates* of Hospitalization due to Asthma by Age Group and Year, All Ages, Michigan, 1990-2003 *Uses 1990-2003 MI population estimates. Data Source: Michigan Inpatient Database, Bureau of Epidemiology, MDCH.

  49. Rates* of Hospitalization due to Asthma by Race, All Ages, Michigan, 2001-2003 *Uses 2002 MI population estimates and age adjusted to the 2000 US standard population. Data Source: Michigan Inpatient Database, Bureau of Epidemiology, MDCH.

  50. Rates* of Hospitalization due to Asthma by Race and Year, All Ages, Michigan, 1990-2003 *Uses 1990-2003 MI population estimates and age adjusted to the 2000 US standard population. Data Source: Michigan Inpatient Database, Bureau of Epidemiology, MDCH.

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